Individual provider Active NPI

Jessica Elizabeth Digiacomo, DPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1013491547
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
14100 SE 36TH St Ste 210
Bellevue, WA 98006-1657
Phone
(425) 653-7100
Fax
(425) 653-7109
NPI assigned
Sep 20, 2018
Last updated
Sep 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

14100 SE 36TH St Ste 210
Bellevue, WA 98006-1657

Mailing address

14100 SE 36TH St Ste 210
Bellevue, WA 98006-1657
Phone (425) 653-7100

Other identifiers 1

IdentifierTypeStateIssuer
PT60876234OtherWAPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181031003285 WA Practitioner - Physical Therapist in Private Practice 4284987637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1013491547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 SE 36TH ST STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061657",
            "telephone_number": "425-653-7100",
            "fax_number": "425-653-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 SE 36TH ST STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061657",
            "telephone_number": "425-653-7100",
            "fax_number": "425-653-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIACOMO",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT60876234",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.